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目的观察血液灌流(HP)联合血液透析(HD)治疗难治性过敏性紫癜(HSP)患儿的疗效。方法将2008年4月-2009年2月于本院住院的难治性HSP患儿随机分为治疗组与对照组各20例,均常规予激素、H2受体阻滞剂、钙剂等药物,治疗组加用HP联合HD,连续治疗3d,每次2h,观察期间不良反应,比较2组患儿的消化道症状、皮疹、激素用量、住院时间等临床指标。并应用SPSS11.0软件进行分析。结果 1.治疗组腹痛、血便等消化道症状改善,且起效时间显著优于对照组(P<0.05);2.治疗组皮疹消退较对照组快,差异有统计学意义(P<0.01);3.住院期间治疗组平均激素用量较对照组显著减少(P<0.01);4.治疗组住院时间短于对照组(P<0.05),但治疗组住院总费用高于对照组;5.HP治疗过程中仅见一过性低血压,无出血、电解质紊乱等不良反应;6.随访治疗组患儿1～11个月,17例病情稳定无反复,对照组11例无反复,差异有统计学意义(P<0.05)。结论 HP联合HD治疗儿童难治性HSP有一定疗效,在改善皮肤、消化道症状方面尤为明显,可较快缓解患儿症状,并可缩短住院时间,减少住院期间激素用量。
Objective To observe the curative effect of hemoperfusion (HP) and hemodialysis (HD) on children with refractory Henoch-Schonlein purpura (HSP). Methods The patients with refractory HSP who were hospitalized in our hospital from April 2008 to February 2009 were randomly divided into treatment group (20 cases) and control group (20 cases), all of which were treated with routine steroid, H2 receptor blocker, calcium and other drugs , The treatment group plus HP combined with HD, continuous treatment 3d, each 2h, observe the adverse reactions during the period, compared two groups of children with gastrointestinal symptoms, rash, hormone dosage, length of stay and other clinical indicators. And use SPSS11.0 software for analysis. Results 1. The treatment group had improvement of gastrointestinal symptoms such as abdominal pain and bloody stool, and the onset time was significantly better than that of the control group (P <0.05). 2. The regression of the rash in the treatment group was faster than that in the control group (P <0.01) (P <0.01); 4. The average length of hospital stay in treatment group was shorter than that in control group (P <0.05), but the total cost of hospitalization in treatment group was higher than that in control group; HP treatment only seen transient hypotension, no bleeding, electrolyte imbalance and other adverse reactions; 6 follow-up treatment group of children 1 to 11 months, 17 cases of stable and non-repetitive, 11 cases of the control group, the difference was statistically Significance (P <0.05). Conclusion HP combined with HD has certain curative effect on refractory HSP in children and is particularly effective in improving the symptoms of skin and gastrointestinal tract. It can relieve the symptoms of children faster, and can shorten the hospital stay and reduce the amount of hormone during hospitalization.